Abstract
Goal: Contribute to improve treatment of patients suffering from urogenital fistula (UGF). Materials and methods: It was a descriptive and prospective study conducted by the United Nations Population Fund (UNFPA) and the Ivorian government, on treatment of fistulas. The caravan took place on 4 periods of 10 days each and has enabled us to recruit 95 patients in the gynecological emergency department of Bouake’s University Hospital Center (UHC) and from the surgical emergencies departments of the regional hospital centers (RHC) of Man and Bondoukou, in Man from 14th to 23rd of August 2013, then from 24th March to 02nd of April 2014; in Bouaké from 06th to 15th of November 2013 and in Bondoukou from 13th to 22nd of December 2013, respectively. Results: Average age of patients was of 30.8 years. 50 patients were single (52.6%). 44.2% of patients were farmers. In 95.8% of cases it was about obstetrical fistulas of which 52.6% were caused by caesareans. Average duration of delivery labor was of 2.3 days. Vesicovaginal fistulas represented 65.3% of UGF. Suture split were carried out on 90 patients (94.7%). Within 01 month, success rate was of 63.9% for 83 known patients. Conclusion: Incidence of UGF in our country is certainly underestimated. They are mainly of obstetrical origin and treatment relies on sutures split which give satisfactory results.
Highlights
In 95.8% of cases it was about obstetrical fistulas of which 52.6% were caused by caesareans
World Health Organization (WHO) estimates that 2 to 3.5 million of women suffer from this pathology in the world and the majority are in Africa [1]
Patients suffering from an incontinence without any related urogenital fistula or non-curable urogenital fistula or vaginal sclerosis already formed; making the reparation of the fistula impossible; and those of which the fistulous orifice have not been found during exploration of vaginal cavity under spinal anesthesia, were discarded from the study
Summary
They are mostly vesicovaginal fistulas which are defined as being an abnormal and permanent communication between bladder and vagina, causing a permanent urine leakage into vagina. UGF mainly caused in developing countries like Cote d’Ivoire is obstetrical and it represents 75% of fistula etiologies, in the age bracket of 15 to 35 years [2].
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